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PERMITTEE NAME/ADDRESS rlncladeFacdhi P.Yarre•'LawrfonitjtiJNnnnrl <br />NAME <br />Tlti _t lrYr INC. <br />ADDRESS <br />:164F3 <br />FACILITY <br />LOCATION . it l ;! E3 1 cS tF <br />4ry I :I. V ',E MAPjAGFR <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM TO <br />Form Approved. <br />OMB No. 2040-0004 <br />NOTE: Read Instructions before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. FREQUENCY <br />OF SAMPLE <br /> ? TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br />ER MEASUREMENT <br />i PERMIT '.,171 REP OFD T <br />i •? :S '.%';I_I ' REQUIREMENT 30r.+A riVC DA 1 L MX <br /> SAMPLE <br /> MEASUREMENT <br />" PERMIT =iEPOPT PEI: <br /> REQUIREMENT 3r? DA A''G ; <br />.. SAMPLE <br />Tr=rr',?`Fs MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br />I SAMPLE <br /> MEASUREMENT <br /> PERMIT 'f R EP oR T <br /> REQUIREMENT CJFt I L` N.. <br /> SAMPLE <br />113TAL. R;- ERZAi3LE' MEASUREMENT <br />I r,c R. PERMIT <br />F FL L)l?l' REQUIREMENT : t A <br />' ! r'1 SAMPLE <br />r?.'•!,L RR?._j, - :• •; : - MEASUREMENT <br /> PERMIT ?F ? h Ef' i i F ., <br />;,; .?c(= REQUIREMENT <br /> SAMPLE <br />EH:. - MEASUREMENT <br /> PERMIT t 2;r F7?I't-F. - F?r. <br /> REQUIREMENT <br />NAMEMTLE PRINCIPAL EXECUTIVE OFFICER I certify under penalty of law that this document and all amichntents were TELEPHONE DATE <br /> <br />S? ?jf CCia4 t >?f ?, prepared under my direction or supmasron m accordance with a system dcsugned <br />to assure that quahfied personnel properly gather and evaluate the information . ? <br /> submitted. Based on my inquiry of the person or persons who numage the system. - " <br />- or those persons directly responsible for gathering the information, the information <br /> <br />' submitted is, to the brat ,,f m. I:no%ledgc and lvhef, we, accnratc, and es•mplCIC. <br />!i <br />emltic, i?,r s <br />tatse infornuuon <br />C <br />am <br />bmittin <br />th <br />t th <br />I SIGNATURE OF PRINCIPAL EXECUTIVE I = ?` <br /> <br />TYPED OR PRINTED . <br />ere.u <br />tgm <br />c <br />p <br />u <br />g <br />tun aware <br />a <br />including the passiMlu} •,! !ins and impnsonmrnt for krwwml vtolnnon• OFFICER OR AUTHORIZED AGENT AREA <br />CODE NUMBER <br />YEAR <br />MO <br />DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />EPA Form 3320.1 (Rev. 3/99) Previous editions may be used. r'•0053 T}1is is a part form.